Provider Demographics
NPI:1275288789
Name:WHITE, COURTNEY E (LPC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PICASSO LN UNIT 6207
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7133
Mailing Address - Country:US
Mailing Address - Phone:854-444-0096
Mailing Address - Fax:
Practice Address - Street 1:402 PICASSO LN UNIT 6207
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-7133
Practice Address - Country:US
Practice Address - Phone:843-284-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional